| NPI | 1457569147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: WI 3930) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701003643) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2012-02-24 |