| NPI | 1720636020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0017359) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO LPCC.0016830) |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2021-07-22 |