| NPI | 1790824811 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NH 620)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 5671)  | 
| Enumeration Date | 2007-02-05 | 
| Last Update Date | 2025-07-16 |