| NPI | 1568704880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401010769) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: GA LPC006602) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2016-10-13 |