| NPI | 1215265905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0701001797) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: DC 115) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |