| NPI | 1710618061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH25735) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 4834) |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2025-01-06 |