| NPI | 1487217378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: LGP9458) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LGP9458) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2019-05-01 |