| NPI | 1023687100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-20471) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-6898T) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2023-03-20 |