| NPI | 1679982912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC6866) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LGP5530) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2023-08-08 |