| NPI | 1407136229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 71849) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-20757) |
| 101YM0800X Counselor, Mental Health (Licence: ID LCPC-8529) | |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2022-10-25 |