| NPI | 1255862405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC A10753) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor (Licence: NC 00117504) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2017-03-21 |