| NPI | 1598201071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 79887) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: LA 6345) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2019-12-20 |