| NPI | 1912208695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ 13531) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ 13531) |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2010-11-10 |