| NPI | 1699488767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2024031901) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 7985-125) |
| Enumeration Date | 2023-01-03 |
| Last Update Date | 2024-10-07 |