| NPI | 1174718068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA 003161) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 53620) |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2014-04-21 |