| NPI | 1538614144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO 0018097) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AL C2637A) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2022-03-15 |