| NPI | 1710416631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC12959) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 262557) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2022-09-15 |