| NPI | 1386658854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IA 95173) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IA 00247) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2021-08-25 |