| NPI | 1508119306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-13461) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LCSW13461) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2014-09-15 |