| NPI | 1245613447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LPC-16111) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 15040) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2016-09-29 |