| NPI | 1740561406 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C5794) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT 1585) | 
| 101YP2500X Counselor, Professional (Licence: OR C4104) | |
| Enumeration Date | 2011-09-07 | 
| Last Update Date | 2020-08-14 |