| NPI | 1578830071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 5500) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 63099) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2017-02-22 |