| NPI | 1922430909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH4477) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL CAP2234) |
| 101YP2500X Counselor Professional (Licence: KS LPC2422) | |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2025-07-10 |