| NPI | 1164914800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-22061) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ 17017) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2023-05-09 |