| NPI | 1316792120 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401224412) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPCC.0019475) | 
| Enumeration Date | 2024-04-23 | 
| Last Update Date | 2024-07-03 |