| NPI | 1679199889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NE 5583) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 12250) |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-12-03 |