| NPI | 1033799911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ INTERN) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ INTERN) |
| 101YP2500X Counselor Professional (Licence: AZ INTERN) | |
| Enumeration Date | 2021-04-13 |
| Last Update Date | 2021-04-13 |