| NPI | 1104375161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 74143) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NJ 000860) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2016-09-30 |