| NPI | 1508267600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OR C5292) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 82747) |
| 101YP2500X Counselor Professional (Licence: NM CCMH0209001) | |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2020-03-17 |