| NPI | 1720352149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401225255) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional (Licence: CO LPC.0012831) | |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2025-07-30 |