| NPI | 1265175863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-20948) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LAC-18477) |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2024-05-16 |