| NPI | 1174620801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 4080) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701003570) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2009-03-09 |