| NPI | 1972154540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0020470) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180.009195) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2024-08-05 |