| NPI | 1962074708 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 4447)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39001912A)  | 
| 101YP2500X Counselor, Professional (Licence: GA LPC012331)  | |
| Enumeration Date | 2021-07-12 | 
| Last Update Date | 2021-09-20 |