| NPI | 1306540372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC23300) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LAC-13775) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2025-05-29 |