| NPI | 1184152605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701007140) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MD LC6101) |
| Enumeration Date | 2017-05-29 |
| Last Update Date | 2018-03-17 |