| NPI | 1992456909 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC13897)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP11608)  | 
| Enumeration Date | 2022-01-11 | 
| Last Update Date | 2025-07-03 |