| NPI | 1568763928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 71987) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OH C1000498) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2014-03-17 |