| NPI | 1649795774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-16853) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor (Licence: 00272365) |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2017-08-10 |