| NPI | 1780118653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL LPC04484) |
| Additional Taxonomies | 225XM0800X Occupational Therapist, Mental Health (Licence: AL 1284) |
| 101YM0800X Counselor, Mental Health (Licence: AL C2696A) | |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2025-10-15 |