| NPI | 1720591878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 73617) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 0014110) |
| Enumeration Date | 2017-11-12 |
| Last Update Date | 2017-11-12 |