| NPI | 1972940971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C5609) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: OR 113217) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2025-12-05 |