| NPI | 1770860421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: AZ RN035891) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC11969) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2011-11-09 |