| NPI | 1255016564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MN 32163) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 134303-121) |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-06-15 |