NPI | 1801940796 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC12890) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC11857) |
101YM0800X Counselor, Mental Health (Licence: AZ LPC12890) | |
Enumeration Date | 2007-01-22 |
Last Update Date | 2024-01-24 |