| NPI | 1770927295 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-14202) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-14202) | 
| Enumeration Date | 2013-04-26 | 
| Last Update Date | 2020-02-12 |