| NPI | 1477061281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401015121) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LPC-22132) |
| 225C00000X Rehabilitation Counselor (Licence: 43621) | |
| Enumeration Date | 2018-01-15 |
| Last Update Date | 2023-09-01 |