| NPI | 1558782854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 5335) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OH E-01648) |
| Enumeration Date | 2014-01-04 |
| Last Update Date | 2014-01-04 |