| NPI | 1336690544 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: OR C5689)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID LPC-6040)  | 
| Enumeration Date | 2016-10-23 | 
| Last Update Date | 2023-03-28 |