| NPI | 1700771557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT BBH-PCLC-LIC-81143) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT BBH-PCLC-LIC-81143) |
| 225700000X Massage Therapist (Licence: MT LMT-LMT-LIC-11885) | |
| Enumeration Date | 2025-06-11 |
| Last Update Date | 2025-08-13 |