| NPI | 1609417740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-23526) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH61249712) |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2025-05-30 |