| NPI | 1720359052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0701003893) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: DC PRC14024) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2012-01-18 |