| NPI | 1407314057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TN 0000000507) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NC 9467) |
| Enumeration Date | 2019-03-02 |
| Last Update Date | 2019-03-03 |