| NPI | 1053465914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 3719-125) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 00271) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-07-09 |