| NPI | 1104242528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 5400-125) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401013488) |
| Enumeration Date | 2014-03-10 |
| Last Update Date | 2024-01-29 |