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Individual
OSHA LANE
Active
Individual
OSHA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW CP 16481
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
16481
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AD01AK
—
SC
Enumeration date
04/20/2018
Last updated
08/27/2025
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