| NPI | 1508930553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WV 1644) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MD LC3123) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2018-07-19 |