| NPI | 1780339200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 005443) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CT 4145) |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2023-09-19 |