| NPI | 1629158001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E0007885) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY KY-0104) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-08 |