| NPI | 1265721567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC006119) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401009213) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2011-04-07 |