| NPI | 1366958464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-20360) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 15112) |
| 101YP2500X Counselor, Professional (Licence: AZ LAC-18244) | |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2022-07-08 |