| NPI | 1952768442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 10661) |
| 101Y00000X Counselor (Licence: AL LPC05345) | |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2024-08-03 |