NPI | 1083231856 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-19292) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LAC-17146) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2020-06-28 |
Last Update Date | 2020-09-25 |