| NPI | 1982139424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 7082) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-21739) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2025-04-08 |