| NPI | 1063832343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-17047) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-13710) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2018-01-09 |