| NPI | 1699046904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: SC 5797) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2012001157) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2015-03-04 |