| NPI | 1063060093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LAC-18036) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: AZ LAC-18036) |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2019-09-17 |