| NPI | 1518239193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 11261) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC-13419) |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2013-04-01 |