| NPI | 1730486713 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401016525)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC1700)  | 
| Enumeration Date | 2011-02-28 | 
| Last Update Date | 2018-11-15 |