| NPI | 1568874477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2014015184) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: KS 2768) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2022-07-26 |