| NPI | 1790301414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 8501) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 4035-226) |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2022-05-20 |