| NPI | 1720695612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM CTB-2023-0395) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R10650) |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2025-11-10 |