| NPI | 1609330927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LPC-2231) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-2231) |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2019-01-31 |