| NPI | 1699365783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 23021) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC013477) |
| Enumeration Date | 2021-01-22 |
| Last Update Date | 2026-06-26 |