| NPI | 1174877328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 6529) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.014720) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2023-03-28 |