| NPI | 1174879928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD ATC130) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101Y00000X Counselor (Licence: VA ATR-BC #14-064) | |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2015-04-09 |