| NPI | 1881807345 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 001801) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 002006) | 
| Enumeration Date | 2007-05-08 | 
| Last Update Date | 2025-09-11 |