| NPI | 1689809600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LCSW-10019) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LASAC-13100) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2009-05-19 |