NPI | 1083978985 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-17976) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-15369) |
101YP2500X Counselor, Professional (Licence: MI 6401013111) | |
Enumeration Date | 2012-06-26 |
Last Update Date | 2021-06-23 |