| NPI | 1619312428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-16160) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-14001) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2017-05-10 |