| NPI | 1629472592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ 17795) |
| Additional Taxonomies | 251S00000X (Licence: AZ 5377149) |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2019-01-24 |