| NPI | 1790077816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401012377) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401012377) |
| Enumeration Date | 2011-05-08 |
| Last Update Date | 2019-04-12 |