| NPI | 1720564701 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 84322) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178013743) | 
| Enumeration Date | 2018-07-12 | 
| Last Update Date | 2021-08-23 |