| NPI | 1588998074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 5753) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 14774) |
| 101YP2500X Counselor Professional (Licence: TX 5758-125) | |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2018-09-18 |