| NPI | 1679757199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC2321) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2020-01-31 |