| NPI | 1891584116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TN 7505) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN 3322) |
| Enumeration Date | 2025-05-02 |
| Last Update Date | 2025-05-02 |