| NPI | 1720221047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ LPC-10578) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 6925) |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2013-02-20 |