| NPI | 1518503630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ Lac-18395) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-18395) |
| Enumeration Date | 2019-11-24 |
| Last Update Date | 2019-11-24 |