| NPI | 1942635735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID 5968) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 14237330-6004) |
| 101YM0800X Counselor, Mental Health (Licence: AZ 24404) | |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2025-11-14 |