| NPI | 1790428324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LPC-21745) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LAC-19024) |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2023-10-19 |