| NPI | 1366888232 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-20955) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0153861) | 
| Enumeration Date | 2013-05-17 | 
| Last Update Date | 2024-11-06 |