NPI | 1336806199 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-21882) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-19183) |
Enumeration Date | 2021-11-29 |
Last Update Date | 2023-03-22 |