NPI | 1255051298 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-23937) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LIAC-15597) |
Enumeration Date | 2022-08-30 |
Last Update Date | 2025-05-22 |