| NPI | 1568620474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY KY1199) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH C1100031) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2023-08-07 |