| NPI | 1629629696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-23952) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: HI MHC-1114) |
| Enumeration Date | 2019-09-21 |
| Last Update Date | 2026-05-21 |