NPI | 1154770634 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC21236) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA LPCC7979) |
Enumeration Date | 2016-06-06 |
Last Update Date | 2023-07-14 |