| NPI | 1649216854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701003322) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC-14494) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2024-01-18 |