| NPI | 1992477731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH21526) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2026-06-01 |