| NPI | 1679848683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ 17500) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CO 6217) |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2018-09-04 |