| 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 |