| NPI | 1235616590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC6987) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 6050) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2018-07-19 |