| NPI | 1235474875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LPC#10043) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LISAC#1435) |
| Enumeration Date | 2012-12-09 |
| Last Update Date | 2012-12-09 |