| NPI | 1912604117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR A16225) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2025-05-22 |