| NPI | 1215466446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 78518) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC7751) |
| Enumeration Date | 2017-06-10 |
| Last Update Date | 2022-05-10 |