| NPI | 1912563776 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101Y00000X Counselor | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 103T00000X Psychologist | |
| 171M00000X Case Manager/Care Coordinator | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-16 | 
| Last Update Date | 2023-06-13 |