| NPI | 1922778802 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IMH21542) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL IMT3572) | 
| Enumeration Date | 2021-09-14 | 
| Last Update Date | 2021-09-14 |