NPI | 1710388095 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-16376) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-13245) |
Enumeration Date | 2014-09-05 |
Last Update Date | 2017-04-23 |