| NPI | 1154947893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AK 149614) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: SD LPC20221) |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-06-18 |