| NPI | 1073013579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401018392) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401016488) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2020-06-19 |