| NPI | 1215590906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-18784) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LAC-16356) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2020-03-11 |