| NPI | 1619640265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID 8331174) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID LPC-8206) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2024-12-09 |