| NPI | 1902885031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-11134) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LPC 11134) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2017-04-23 |