| NPI | 1750977518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: ME CC5854) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 75448) |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2020-12-16 |