| NPI | 1376864678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-12958) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ SA-10967) |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2012-05-01 |