| NPI | 1760799605 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-6410) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-24300) | 
| Enumeration Date | 2010-09-13 | 
| Last Update Date | 2025-10-09 |