| NPI | 1225388762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701007010) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MD LC3920) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2019-03-04 |