| NPI | 1740683564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401017644) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E. 1200475) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2022-04-29 |