| NPI | 1053749374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 5538) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH c0500780) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2014-10-28 |