| NPI | 1780105114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-16585) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ 16585) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2024-12-05 |