| NPI | 1679961320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.1700386) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH C.1300582) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2017-12-11 |