| NPI | 1063924140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS 2507) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2012032164) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2017-10-30 |