| NPI | 1407918543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 80762) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401009011) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2026-06-16 |