NPI | 1407006380 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC 13230) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC 11863) |
Enumeration Date | 2008-09-26 |
Last Update Date | 2015-04-06 |