| NPI | 1902148059 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 1642-226) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional | 
| 103TC1900X Psychologist, Counseling (Licence: WI 5630-125) | |
| Enumeration Date | 2013-03-26 | 
| Last Update Date | 2021-03-05 |