NPI | 1558494096 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-0338) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AZ LMFT-0177) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2007-07-08 |