NPI | 1831406388 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-17147) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-15077) |
Enumeration Date | 2010-09-04 |
Last Update Date | 2021-12-20 |