| NPI | 1720558059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 640101753) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401016468) |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2019-07-30 |