| NPI | 1154105724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: KY 257697) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NM SWB-2023-0812) |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2023-08-23 |