| NPI | 1861847808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-17629) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LAC-16023) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2018-10-11 |