| NPI | 1790403970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-20596) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LPC-20596) |
| Enumeration Date | 2022-08-15 |
| Last Update Date | 2022-08-15 |