| NPI | 1962485250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-10792) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ LPC10792) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2019-01-06 |