| NPI | 1316144785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LAC11954) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC 13389) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2011-02-04 |