| NPI | 1962094177 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 8255859-6009)  | 
| Additional Taxonomies | 101Y00000X Counselor | 
| Enumeration Date | 2021-02-09 | 
| Last Update Date | 2021-09-21 |