| NPI | 1205160249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LAC 12816) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LISAC 11366) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2009-09-23 |