| NPI | 1639389547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-1511) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ 1511) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2017-04-23 |