| NPI | 1639572258 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.2202737)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC-17685)  | 
| 101YP2500X Counselor, Professional (Licence: OH C.1200622)  | |
| Enumeration Date | 2014-09-28 | 
| Last Update Date | 2022-02-08 |