| NPI | 1285745737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC19140) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: WA 126800000x3) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-04-25 |