NPI | 1154715076 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-17039) |
Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LAC 14549) |
101YM0800X Counselor, Mental Health (Licence: KS LCPC-03104) | |
Enumeration Date | 2015-03-28 |
Last Update Date | 2023-04-27 |