| NPI | 1710334057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 5477) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MS 2690) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2023-01-30 |