NPI | 1609457019 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC23434) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NV CI3342) |
101Y00000X Counselor (Licence: AZ LAC-19255) | |
Enumeration Date | 2021-04-16 |
Last Update Date | 2025-01-14 |