| NPI | 1124633821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NY 119011) |
| 251S00000X (Licence: NY 119011) | |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2020-09-10 |