| NPI | 1770853574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 5157-125) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: KY KY-1567) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2013-08-31 |