| NPI | 1558790360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC5376) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA 0701006398) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2019-04-02 |