| NPI | 1760563894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 1249) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 2972) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-08 |