| NPI | 1316228240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701006182) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WV 1689) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2015-07-01 |