| NPI | 1790832467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-10841) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC-11218) |
| 106H00000X Marriage & Family Therapist (Licence: AZ LMFT-10162) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2007-07-08 |