| NPI | 1164804274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OR C5806) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 6504-125) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2025-11-12 |