| NPI | 1902562895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CO LPC.0019575) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MT BBH-LCPC-LIC-50152) |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2023-12-14 |