| NPI | 1790159002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 105746) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 1205) |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2016-05-26 |