| NPI | 1073220034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 295755) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WV F938661) |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2024-11-20 |