| NPI | 1104307438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC11528) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2022-01-27 |