| NPI | 1700222122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-15211) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ 13772) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2022-07-06 |