| NPI | 1841754199 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ 19368) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-17241) | 
| Enumeration Date | 2019-01-30 | 
| Last Update Date | 2023-03-06 |