| NPI | 1154487882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4806) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT 1158) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2021-07-30 |