NPI | 1609174697 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC3795) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37PC00396600) |
Enumeration Date | 2011-03-01 |
Last Update Date | 2018-03-17 |