| NPI | 1588191878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LPC-18822) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LAC-16663) |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2020-03-17 |