| NPI | 1831469055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LPC-1211) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ lpc12111) |
| 101YM0800X Counselor, Mental Health (Licence: AZ lpc-1211) | |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-10-08 |