| NPI | 1548675366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 239818) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 239818) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2021-05-11 |