| NPI | 1255973574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: KY 276571) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 260206) |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2022-04-12 |