| NPI | 1639465040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LISAC-1263) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-10880) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2011-06-23 |