| NPI | 1124459789 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC9826)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: DC PRC14405)  | 
| Enumeration Date | 2013-12-09 | 
| Last Update Date | 2021-02-22 |