| NPI | 1124490180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 74523) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC007519) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2015-10-29 |