| NPI | 1689872350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LPC-0062) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LPC-0062) |
| 101YP2500X Counselor, Professional (Licence: AZ LPC-0062) | |
| 101YS0200X Counselor, School (Licence: AZ LPC-0062) | |
| 106H00000X Marriage & Family Therapist (Licence: AZ LPC-0062) | |
| Enumeration Date | 2007-07-04 |
| Last Update Date | 2025-09-11 |