| NPI | 1790716694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180-000275) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 1509-125) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2007-07-08 |