| NPI | 1699434142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 259355) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WV TH00947164) |
| 101YM0800X Counselor, Mental Health (Licence: VA 0904017909) | |
| Enumeration Date | 2021-12-13 |
| Last Update Date | 2025-10-14 |