| NPI | 1629057617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LPC12139) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ 12139) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2007-07-24 |