| NPI | 1528563376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC3656) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA 0701006541) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-03-21 |