| NPI | 1093016602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC #12096) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ SA 1399) |
| Enumeration Date | 2010-11-12 |
| Last Update Date | 2010-11-12 |