| NPI | 1942795596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-19584) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PR 5936) |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2021-11-15 |