| NPI | 1740830561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH25453) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 20198) |
| 101YM0800X Counselor Mental Health (Licence: SC 7945) | |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2025-08-01 |