| NPI | 1609976620 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005278)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC2012)  | 
| Enumeration Date | 2006-09-22 | 
| Last Update Date | 2020-12-14 |