| NPI | 1528576642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NJ 44SL06335400) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA SW131295) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2018-01-11 |