NPI | 1801291158 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC 13852) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS 2498) |
101YP2500X Counselor, Professional (Licence: ID LCPC-5212) | |
Enumeration Date | 2014-10-29 |
Last Update Date | 2014-10-29 |