| NPI | 1164155321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-21002) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LAMFT-10894) |
| 101YP2500X Counselor, Professional (Licence: CT 7602) | |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2025-02-03 |