| NPI | 1184675050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 6476) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401008905) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2007-07-08 |