| NPI | 1952551210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ LPC-12995) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC12995) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2024-06-12 |