| NPI | 1922546290 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-18487)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ 15802)  | 
| Enumeration Date | 2017-02-07 | 
| Last Update Date | 2020-12-14 |