| NPI | 1851611594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IA 001407) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 64177) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2022-12-01 |