| NPI | 1508401787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OH C1902176) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6401017007) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2020-09-07 |