| NPI | 1275012023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID 7087) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 79621) |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2021-06-08 |