| NPI | 1114905668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 4573-125) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401002776) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2012-12-20 |