| NPI | 1083839112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2005035879) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS 250) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-07-08 |