| NPI | 1164164950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0016732) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: ME CC6177) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-12 |