| NPI | 1265817555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401018242) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: MI 6401014385) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2023-05-08 |