| NPI | 1770525610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-10665) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-10565) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-08-13 |