| NPI | 1790137842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2507) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NE 1957) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2025-09-08 |