| NPI | 1568652063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 72896) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401010656) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2023-08-18 |