| NPI | 1730635830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60936946) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID 5071146) |
| 101YP2500X Counselor, Professional (Licence: CO LPC.0021642) | |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2025-10-08 |