| NPI | 1902917545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AK LPC 34) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AK LPC 34) |
| 101YP2500X Counselor, Professional (Licence: AK LPC 34) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |