| NPI | 1104523497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0704014291) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 07040142) |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2023-02-16 |