NPI | 1043805898 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-17727) |
Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LAC-17727) |
Enumeration Date | 2021-03-03 |
Last Update Date | 2022-11-21 |