| NPI | 1609268036 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-21671)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD ATC044)  | 
| 221700000X Art Therapist (Licence: ATC044)  | |
| Enumeration Date | 2015-02-23 | 
| Last Update Date | 2023-01-18 |