NPI | 1962754515 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-12889) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 41978) |
Enumeration Date | 2012-10-05 |
Last Update Date | 2012-10-05 |