| NPI | 1669087052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ LPC20801) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LAC-15775) |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2022-10-03 |