| NPI | 1669925103 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC8845)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LGP7235)  | 
| Enumeration Date | 2016-08-02 | 
| Last Update Date | 2024-01-05 |