| NPI | 1083639959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: PA PC10567) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 18621) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-01-08 |