NPI | 1386183135 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-16033) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID LCPC-7532) |
Enumeration Date | 2017-02-13 |
Last Update Date | 2020-01-30 |