NPI | 1174075758 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC 15984) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC 15984) |
Enumeration Date | 2016-10-28 |
Last Update Date | 2016-10-28 |