| NPI | 1225193790 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ NCC-75942) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-10648) | 
| 101YM0800X Counselor, Mental Health (Licence: AZ LPC-10984) | |
| Enumeration Date | 2006-12-26 | 
| Last Update Date | 2025-09-11 |