| NPI | 1508140856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI CC-NRY 160519301) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH MM1-00-6550) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-05 |