| NPI | 1962173302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-24147) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID 7386) |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2025-12-18 |