| NPI | 1912669144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IL 180.017139) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: IL 178.019097) |
| 106H00000X Marriage & Family Therapist (Licence: IL 208.001085) | |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2025-05-16 |