| NPI | 1841021128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: PA PC017970) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 79777) |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2024-12-23 |