| NPI | 1336332279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-15548) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ 757435) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2017-12-19 |