| NPI | 1184266157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MO 2019042839) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KS 2850) |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2020-09-24 |