| NPI | 1124669361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-18548) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LAC-16714) |
| Enumeration Date | 2019-09-29 |
| Last Update Date | 2019-11-13 |