| NPI | 1063873487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC14498) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LPC14498) |
| Enumeration Date | 2016-03-12 |
| Last Update Date | 2018-03-17 |