| NPI | 1417377367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LPC-16214) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH E.1200196) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2018-05-30 |