| NPI | 1053772632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 12178) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A12178) |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2022-02-04 |