| NPI | 1770856965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC9739) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E1100175-SUPV) |
| Enumeration Date | 2012-02-17 |
| Last Update Date | 2023-03-06 |