| NPI | 1720247836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-11909) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LISAC-1359) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2014-09-24 |