| NPI | 1063869337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-18282) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 3012-226) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2022-06-17 |