| NPI | 1912789660 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 2022011342) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: 297566) | 
| 101YS0200X Counselor, School (Licence: MO 339799) | |
| Enumeration Date | 2023-10-17 | 
| Last Update Date | 2025-09-04 |