| NPI | 1770062739 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 005730) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CT 5730) | 
| 101YM0800X Counselor, Mental Health (Licence: TX 73859) | |
| Enumeration Date | 2018-08-10 | 
| Last Update Date | 2024-02-28 |