| NPI | 1639633100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-18532) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2015002773) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-11-21 |