| NPI | 1568978302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2017041932) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MS 2017041932) |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2017-12-15 |