| NPI | 1710586052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 01912) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304498) |
| 101YM0800X Counselor, Mental Health (Licence: NY 014274-01) | |
| 101YM0800X Counselor, Mental Health (Licence: CT 6165) | |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2025-07-15 |