| NPI | 1760736276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC6144) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC006601) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2015-03-10 |