| NPI | 1801132790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0005612) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CO 5612) |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2022-07-21 |