| NPI | 1750859591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701012189) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 16451) |
| 101YM0800X Counselor, Mental Health (Licence: MD LC12210) | |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2025-11-13 |