| NPI | 1801399936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401008480) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 1217) |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |