| NPI | 1477106292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-20678) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LAC-17357) |
| Enumeration Date | 2019-07-21 |
| Last Update Date | 2023-05-08 |