| NPI | 1699273888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401015397) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO LPC.0015042) |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2024-05-20 |