NPI | 1386184059 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-18888) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-5814T) |
Enumeration Date | 2017-03-01 |
Last Update Date | 2022-06-21 |