| NPI | 1073797650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701002241) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MD LC-1071) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2014-03-13 |