| NPI | 1629314133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 66559) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 262193) |
| Enumeration Date | 2013-01-02 |
| Last Update Date | 2022-05-18 |