| NPI | 1174767560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 5285) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: SC 5068) |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2019-05-09 |