| NPI | 1609244235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AL 4002) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AL 2-055887) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2019-03-27 |