| NPI | 1902400252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 18280) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH20279) |
| 101YM0800X Counselor, Mental Health (Licence: SC 8429) | |
| Enumeration Date | 2020-11-27 |
| Last Update Date | 2026-06-19 |