| NPI | 1700570652 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH25226) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH23809) | 
| Enumeration Date | 2023-06-05 | 
| Last Update Date | 2025-04-25 |