NPI | 1326444969 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-20859) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-17349) |
Enumeration Date | 2014-11-10 |
Last Update Date | 2025-01-09 |