| NPI | 1386782662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701004182) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA LPC 0701004182) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2019-10-11 |