| NPI | 1841765484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2021030536) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: KS 3314) |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2021-12-15 |