NPI | 1699059006 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-13722) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC 13722) |
Enumeration Date | 2011-10-04 |
Last Update Date | 2024-01-09 |