| NPI | 1467778621 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-14213)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-13244)  | 
| Enumeration Date | 2010-04-13 | 
| Last Update Date | 2013-07-15 |