| NPI | 1700646346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MT BBH-PCLC-LIC-78067) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-88244) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2026-03-31 |