| NPI | 1194200774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MO 2018033175) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KS 3306) |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2018-09-28 |