| NPI | 1124422753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2015040562) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS 2684) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2016-08-23 |