| NPI | 1962111583 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH25801)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH19661)  | 
| Enumeration Date | 2022-11-22 | 
| Last Update Date | 2025-08-12 |