| NPI | 1306415922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MD LC11946) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD LGP9989) | |
| Enumeration Date | 2021-06-18 |
| Last Update Date | 2022-01-31 |