| NPI | 1790803096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NE 2146) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IA 981) |
| 101Y00000X Counselor (Licence: 50970) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2007-07-08 |