| NPI | 1104036664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.0500154) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401008894) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2019-04-12 |