| NPI | 1790204428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2016035424) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 16754) |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2021-06-04 |