| NPI | 1902092885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AZ LPC-11726) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LISAC-10520) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2007-11-28 |