| NPI | 1790407013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-24241) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN LPC-MN-749) |
| 101YP2500X Counselor, Professional (Licence: OH LPC-OH-750) | |
| Enumeration Date | 2022-09-13 |
| Last Update Date | 2026-04-08 |