| NPI | 1396091658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID LCPC6264) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID LPC3694) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2020-11-04 |