| NPI | 1922621242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: AZ 4765) |
| Additional Taxonomies | 103TP2701X Psychologist Group Psychotherapy (Licence: AZ 4765) |
| 101YP2500X Counselor Professional (Licence: AZ LPC-2539) | |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2020-05-20 |