| NPI | 1699081729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-12235) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LPC-12235 LISAC-1330) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LISAC-1330) | |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2010-08-26 |