NPI | 1760917553 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-16755) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC16755) |
101YM0800X Counselor, Mental Health (Licence: MI 6401013734) | |
101YP2500X Counselor, Professional (Licence: MI 6401013734) | |
Enumeration Date | 2017-04-29 |
Last Update Date | 2025-02-04 |