| NPI | 1871884767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-19972) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LPC-19972) |
| 101YP2500X Counselor Professional (Licence: CO 2127) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2021-06-16 |