| NPI | 1376968396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-19338) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 6249-125) |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2024-03-13 |