| NPI | 1053656629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701005378) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OR C2976) |
| Enumeration Date | 2012-12-07 |
| Last Update Date | 2012-12-07 |