| NPI | 1851453153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO #5498) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LAC-12466) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2010-05-26 |