| NPI | 1134740210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 7785-125) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WI 3172-146) |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2020-04-30 |