| NPI | 1720774870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM CTB-2025-0691) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC015356) |
| 101YM0800X Counselor, Mental Health (Licence: DE PC-0011530) | |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2026-01-13 |