| NPI | 1649752403 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID 9023) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID 6969) | 
| Enumeration Date | 2018-08-29 | 
| Last Update Date | 2023-08-01 |