NPI | 1063778116 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-22980) |
Additional Taxonomies | 101Y00000X Counselor |
101Y00000X Counselor (Licence: AZ LAC-20242) | |
101YM0800X Counselor, Mental Health (Licence: AZ LMSW-19977) | |
Enumeration Date | 2012-04-03 |
Last Update Date | 2024-06-17 |