| NPI | 1730967241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A19016) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC A19016) |
| 101YP2500X Counselor, Professional (Licence: NC A19016) | |
| 101YS0200X Counselor, School (Licence: NC 1258259) | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NC A19016) | |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2025-08-18 |