| NPI | 1770021180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-17403) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-15450) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2020-06-17 |