| NPI | 1093188039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA 005188) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SC 5609) |
| 251S00000X | |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2016-03-25 |