| NPI | 1073913513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2016039243) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 72735) |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2023-12-26 |