NPI | 1124261102 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-13205) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-13205) |
Enumeration Date | 2009-04-07 |
Last Update Date | 2010-10-05 |