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 |