| NPI | 1205390507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 5704) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC10423) |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2023-06-12 |