| NPI | 1861957466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-24018) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 101YM0800X Counselor, Mental Health (Licence: AZ LAC-21844) | |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2026-05-08 |