| NPI | 1316641061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ LPC-20924) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LASAC-15311) |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2023-03-28 |