| NPI | 1639777220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ LPC-19259) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AZ 19259) |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2023-06-01 |