| NPI | 1215428412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 10535) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VT 068.0072695) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-09-11 |