| NPI | 1497110423 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C5163)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OR R3925)  | 
| Enumeration Date | 2015-12-17 | 
| Last Update Date | 2019-03-04 |