| NPI | 1447482807 |
|---|---|
| Former Name | VIRGINIA INTELISANO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2013036151) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180012457) |
| Enumeration Date | 2009-08-19 |
| Last Update Date | 2019-08-22 |