| NPI | 1518467463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C6127) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC-17151) |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2021-07-22 |