| NPI | 1912463217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC19586) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC19586) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2024-02-05 |