| NPI | 1083115703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701006970) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 64010105644) |
| 101YP2500X Counselor, Professional (Licence: CO 0012999) | |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2023-11-11 |