| NPI | 1104219435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0011704) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: CO 267560) |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-03-11 |