| NPI | 1609996735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-10884) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LPC10884) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2017-04-23 |