| NPI | 1477916732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LGP6240) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD ATC117) |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2016-04-03 |