| NPI | 1023649928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: KY 100310) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: 100310) |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2020-01-29 |