| NPI | 1073671947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS 268) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2001022601) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2007-07-08 |