| NPI | 1811121353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 6751) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 59395) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2011-08-17 |