| NPI | 1487602892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701005366) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: SC 3467) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2012-12-13 |