NPI | 1124677802 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ LCSW-18022) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LCSW-10822) |
Enumeration Date | 2019-09-05 |
Last Update Date | 2022-05-03 |