| NPI | 1861993503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701009917) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 78593) |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2022-08-18 |