| 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 |