| NPI | 1700338928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-27105) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101Y00000X Counselor | |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2026-03-17 |