| NPI | 1205110285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-13542) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-12575) |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2011-10-07 |