| NPI | 1063879658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ LPC18345) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LAC-5593T) |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2021-08-01 |