| NPI | 1225779119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC2329) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LPC2329) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-04-05 |