| NPI | 1578242764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA MC61486343) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG61495202) |
| 101Y00000X Counselor (Licence: ID LPC-9553) | |
| Enumeration Date | 2023-07-14 |
| Last Update Date | 2023-10-18 |