| NPI | 1356064612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-21709) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-7501T) |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2023-02-23 |