| NPI | 1902545882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-23266) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ 20835) |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2024-08-19 |