| NPI | 1104277615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 3207) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor Professional (Licence: CT 003207) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2018-03-17 |