| NPI | 1134512775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 168174) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2013014933) |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2022-04-04 |