NPI | 1639477839 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2008010191) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS LPC 2202) |
Enumeration Date | 2011-03-11 |
Last Update Date | 2012-05-29 |