| NPI | 1053703496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 11679) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 070106041) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2016-02-05 |