| NPI | 1679643977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 0015269) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC11903) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2021-05-08 |