| NPI | 1104210293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MS 0998) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MS 0998) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2019-01-04 |