| NPI | 1821613753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-22076) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-6514T) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2024-02-20 |