| NPI | 1992401855 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401008239)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH21595)  | 
| Enumeration Date | 2023-02-02 | 
| Last Update Date | 2023-02-02 |