| NPI | 1679241392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ 20176) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ 20176) |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2021-08-30 |