| NPI | 1992224604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-25005) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AZ LP032336) |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2026-08-07 |