| NPI | 1013068840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OR C4401) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AZ LPC 1328) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2017-03-23 |