| NPI | 1700256278 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC009893)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH61339763)  | 
| Enumeration Date | 2015-09-28 | 
| Last Update Date | 2022-12-10 |