| NPI | 1649821935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 63711) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA 009062) |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2019-09-27 |