| NPI | 1659687911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 264041) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: KY 50159478) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2022-09-21 |