| NPI | 1619612298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LAC-20906) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LAC-20906) |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2022-04-28 |