| NPI | 1053876870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WV 2330) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 263839) |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2021-11-29 |