| NPI | 1144796368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC19126) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-16859) |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2021-09-23 |