| NPI | 1568482057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401013609) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AK 16) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2013-10-23 |