| NPI | 1114916574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 1282) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 0019290) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2024-04-29 |