| NPI | 1043272164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LISAC-11404) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LPC-11608) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2014-08-26 |