| NPI | 1912031683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID LCPC-2738) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-2738) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2025-09-11 |