| NPI | 1730379124 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: 7038)  | 
| Additional Taxonomies | 171400000X Health & Wellness Coach (Licence: NJ 01222)  | 
| 174H00000X Health Educator (Licence: NY 7038)  | |
| Enumeration Date | 2007-07-31 | 
| Last Update Date | 2023-03-04 |