| NPI | 1609250679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: GA LPC013148) |
| 101YP2500X Counselor Professional (Licence: WI 7528-125) | |
| Enumeration Date | 2015-07-19 |
| Last Update Date | 2024-03-13 |