| NPI | 1477930170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701005293) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 19157) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2015-05-01 |