| NPI | 1740799014 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14382) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL MH14382) | 
| 101YP2500X Counselor, Professional (Licence: FL MH14382) | |
| 106H00000X Marriage & Family Therapist (Licence: FL MH14382) | |
| 225800000X Recreation Therapist (Licence: FL MH14382) | |
| Enumeration Date | 2017-09-29 | 
| Last Update Date | 2023-03-18 |