| NPI | 1104128628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.1000189-SUPV) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2010-12-04 |
| Last Update Date | 2019-02-24 |