| NPI | 1588208268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-17995) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ 17995) |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2021-01-04 |