| NPI | 1073737466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 5164) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ 12893) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2014-06-08 |