| NPI | 1093028664 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-15269)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-13465)  | 
| Enumeration Date | 2010-07-23 | 
| Last Update Date | 2014-09-29 |