| NPI | 1679245971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA MC61095726) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OR R7143) |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2021-10-05 |