| NPI | 1700403466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 18546) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701009354) |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2026-04-17 |