NPI | 1023595451 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-19476) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ A6) |
Enumeration Date | 2018-07-28 |
Last Update Date | 2024-03-07 |