| NPI | 1154681963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C2898) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NM 92271) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |