| NPI | 1770842403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AZ LMFT 10143) |
| Additional Taxonomies | 171W00000X Contractor |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2012-11-08 |