| NPI | 1700605078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: RI MHC02060) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 91987) |
| Enumeration Date | 2024-10-04 |
| Last Update Date | 2026-06-15 |