| NPI | 1164892485 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-15761)  | 
| Enumeration Date | 2015-09-29 | 
| Last Update Date | 2021-02-17 |