| 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 |