| NPI | 1396143590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401014557) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 69737) |
| Enumeration Date | 2014-12-21 |
| Last Update Date | 2016-03-28 |