| NPI | 1760917553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-16755) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401013734) |
| 101YM0800X Counselor Mental Health (Licence: AZ LPC16755) | |
| 101YM0800X Counselor Mental Health (Licence: MI 6401013734) | |
| Enumeration Date | 2017-04-29 |
| Last Update Date | 2021-03-30 |