| NPI | 1275954505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY 1661) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 11578) |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2018-04-10 |