| NPI | 1720454937 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 8389) | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 101YM0800X Counselor, Mental Health (Licence: CA 2613) | |
| 101YP2500X Counselor, Professional (Licence: CA 2613) | |
| Enumeration Date | 2015-08-11 | 
| Last Update Date | 2022-08-02 |