| NPI | 1457592750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LPC 0385) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LISAC 0291) |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2009-03-16 |