NPI | 1538315098 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-11156) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-10954) |
Enumeration Date | 2008-08-14 |
Last Update Date | 2017-04-23 |