| NPI | 1275871113 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-14057)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-14057)  | 
| Enumeration Date | 2013-01-28 | 
| Last Update Date | 2024-03-14 |