| NPI | 1740668557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 60821) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801079244) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2023-10-10 |