| NPI | 1902419583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: KY 282812) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 282812) |
| 101YM0800X Counselor, Mental Health (Licence: KY 282812) | |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2025-09-15 |