| NPI | 1548596950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IA 095875) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LPC-11902) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2023-11-30 |