| NPI | 1750411419 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC0169)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC0207)  | 
| Enumeration Date | 2007-03-06 | 
| Last Update Date | 2016-11-30 |