NPI | 1578123717 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC11313) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LGP9400) |
Enumeration Date | 2019-06-19 |
Last Update Date | 2021-11-28 |