| NPI | 1740310366 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC 10776) | 
| Additional Taxonomies | 101YS0200X Counselor, School | 
| Enumeration Date | 2007-03-06 | 
| Last Update Date | 2012-09-19 |