| NPI | 1063544302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY 110) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: UT 5374018-6004) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2012-05-27 |