| NPI | 1578706719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC 6887) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LPC-12512) |
| 101Y00000X Counselor (Licence: MI 6401007027) | |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2009-04-17 |