| NPI | 1164719662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 4036) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 3498) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2011-07-05 |