| NPI | 1750770129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 69423) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 69423) |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-01-22 |