NPI | 1043921760 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LPC-20594) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-20594) |
Enumeration Date | 2022-12-13 |
Last Update Date | 2023-01-27 |