| NPI | 1871646802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ lpc-10225) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: UT 319064-6004) |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2007-07-08 |