| NPI | 1174995229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ LAC-15795) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LAC-15795) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-10-28 |