| NPI | 1770002040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ 15932-AZ) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: AZ LPC-15932) |
| 106H00000X Marriage & Family Therapist (Licence: AZ LPC-15932) | |
| 101YM0800X Counselor, Mental Health (Licence: AZ LPC-15932) | |
| 101YP2500X Counselor, Professional (Licence: AZ LPC-15932) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LPC-15932) | |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2022-07-21 |