| NPI | 1720454937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| 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 | 2026-04-20 |