| NPI | 1720242399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-17575) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MN LPC00616) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2023-08-22 |