| NPI | 1700414083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC10683) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WV 2499) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2020-09-18 |