| NPI | 1548523731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC5543) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LGP3731) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2014-03-18 |