| 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 |