| NPI | 1336673342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401224919) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MN 03194) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2025-11-17 |