| NPI | 1063832343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ PSY-005890) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-13710) |
| 101YP2500X Counselor, Professional (Licence: AZ LPC-17047) | |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2025-05-13 |