| NPI | 1174842264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC11789) |
| Additional Taxonomies | 385HR2055X Respite Care Respite Care, Mental Illness, Child (Licence: AZ 2281558) |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2023-10-24 |