| NPI | 1134324643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ 12683) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AZ LPC-12683) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2015-01-13 |