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 |