| NPI | 1518107192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC-15559) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-15026) | |
| Enumeration Date | 2009-02-23 |
| Last Update Date | 2024-05-17 |