| NPI | 1669986808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC17358) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC15789) |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2026-08-11 |