| NPI | 1629460324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 89979) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701006105) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2024-07-15 |