| NPI | 1124422134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 72204) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL TPMC3412) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2023-08-01 |