| NPI | 1912256330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 3221) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 10822) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2025-12-09 |