| NPI | 1659840635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO LPC.0016101) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO LPCC.0015792) |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2021-02-03 |