| NPI | 1558988774 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LPC-21431)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LAC-19073)  | 
| Enumeration Date | 2020-07-03 | 
| Last Update Date | 2023-05-26 |