| NPI | 1578055604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC21954) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 75795) |
| 101YP2500X Counselor, Professional (Licence: AZ LPC21954) | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2025-07-03 |