| NPI | 1407299597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO 0012392) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA 0701005239) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2015-08-14 |