| NPI | 1962055616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2023049921) |
| 1041C0700X Social Worker, Clinical (Licence: KS 03328) | |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2025-05-08 |