| NPI | 1104564558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC23135) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-19485) |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2025-01-14 |