| NPI | 1184771388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LPC12176) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-12176) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2010-10-08 |