| NPI | 1780619510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: KS 033) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MO 001791) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2007-07-08 |