| NPI | 1821320912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MN 01049) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 4300-125) |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2021-01-26 |