| NPI | 1407109036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401014492) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH E.0800496) |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2015-08-13 |