| NPI | 1669539763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2004010906) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: KS 908) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2007-07-09 |