| NPI | 1154770113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-17899) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-15833) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2019-06-03 |