| NPI | 1831767136 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-23179)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ND 1137-6-15-21)  | 
| Enumeration Date | 2021-06-14 | 
| Last Update Date | 2024-07-23 |