NPI | 1205596772 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ LPC-22690) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AZ LAMFT-10870) |
Enumeration Date | 2021-12-27 |
Last Update Date | 2023-12-16 |