| NPI | 1740635515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-18415) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401014845) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2023-09-21 |