| NPI | 1962940205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 5724) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO 5724) |
| 101Y00000X Counselor (Licence: AZ 17585) | |
| 101YM0800X Counselor, Mental Health (Licence: AZ 17585) | |
| 101YM0800X Counselor, Mental Health (Licence: CO 5724) | |
| 101YP2500X Counselor, Professional (Licence: AZ 17585) | |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2020-04-01 |