| NPI | 1255917456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ LPC-19657) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AZ LPC-19657) |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2024-01-09 |