| NPI | 1255932695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-19389) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-17453) |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2021-11-10 |