NPI | 1396080883 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-16031) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2012-12-10 |
Last Update Date | 2018-03-17 |