| NPI | 1760998785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C3574) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID LCPC-5302) |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2017-12-28 |