| NPI | 1588786040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 65286) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AK 400) |
| 101YP2500X Counselor, Professional (Licence: OR C2505) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2012-01-10 |