| NPI | 1063990943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 266389) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 241545) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2021-09-22 |