| NPI | 1235488776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.011705) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 6425-125) |
| 101YP2500X Counselor, Professional (Licence: CO 12750) | |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2020-08-03 |