| NPI | 1790357804 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH3962) | 
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: FL MH3962) | 
| Enumeration Date | 2021-07-16 | 
| Last Update Date | 2021-07-16 |