| NPI | 1063779064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 5534) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 66797) |
| 101YP2500X Counselor, Professional (Licence: OH C0800111) | |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2013-06-11 |