| NPI | 1710105796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 3529) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 12440) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2016-12-06 |