| NPI | 1720307911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KY 102202) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 1031) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2019-09-26 |