| NPI | 1265766687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ LPC-13906) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LAC-13289) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2012-04-17 |