| NPI | 1609214436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 003562) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA 0701008149) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2019-03-11 |