| NPI | 1790176345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC21503) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-21503) |
| 101YM0800X Counselor, Mental Health (Licence: AZ LPC21503) | |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2023-08-17 |