| NPI | 1164980785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC11859) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LGP9262) |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2024-01-05 |