| NPI | 1205919271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-12830) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-11972) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2011-10-22 |