NPI | 1124783592 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-21823) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-17145) |
Enumeration Date | 2021-11-01 |
Last Update Date | 2023-09-22 |