| NPI | 1346496809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-2298) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: LISAC-10106) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2008-08-14 |