| NPI | 1144651910 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 74623) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY KY-1709) | 
| Enumeration Date | 2013-12-04 | 
| Last Update Date | 2019-03-11 |