| NPI | 1760994024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: ME XL6411) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MI 6451017659) |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2024-08-15 |