| NPI | 1740653898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA LPC9970) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 9970) |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2026-03-23 |