| NPI | 1063779536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: PA PC015868) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 64435) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2023-12-29 |