| NPI | 1164052809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC011864) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 65960) |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-01-22 |