| NPI | 1053863977 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC7191) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC009317) | 
| Enumeration Date | 2016-10-26 | 
| Last Update Date | 2018-03-17 |