| NPI | 1619988235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC2210) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701004003) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2007-07-08 |