| NPI | 1861842551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH S1201244) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH 121156) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-14 |