| NPI | 1760026694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH C.2002425) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701008730) |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2022-04-21 |