| NPI | 1194190694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC18186) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 133V00000X Dietitian, Registered (Licence: AZ LPC-18186) | |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2019-08-07 |