| NPI | 1568815074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SD 20687) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY 1579) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2022-07-23 |