| NPI | 1548768914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-16026) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2026-06-25 |