| NPI | 1316297922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-18604) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ 18604) |
| 101YM0800X Counselor, Mental Health (Licence: NC 9560) | |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2023-07-13 |