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 |