| NPI | 1487934592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401013729) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 65816) |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2015-01-07 |