| NPI | 1609167691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0014571) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: CO MT.0012483) |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2020-05-11 |