| NPI | 1477152882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 74389) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CO 15009) |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2020-10-19 |