| NPI | 1114961141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WV 1916) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MD LC2125) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-08-30 |