| NPI | 1861934200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ LPC20453) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LAC-14049) |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2022-07-01 |