| NPI | 1700110061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NM CCMH0223691) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AK 939) |
| 101YM0800X Counselor, Mental Health (Licence: CO 0013560) | |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2025-08-04 |