| NPI | 1730457052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0012914) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC12432) |
| 101YM0800X Counselor, Mental Health (Licence: MO 2010041594) | |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2025-10-06 |