| NPI | 1245858182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401017569) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: MI SC0000001003689) |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-07-08 |