NPI | 1154961464 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-18672) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ 18672) |
Enumeration Date | 2020-01-14 |
Last Update Date | 2025-07-01 |