| NPI | 1427304039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO 0013616) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: KS 2134) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2019-01-10 |