| NPI | 1871765214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MA 398268) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2025-04-13 |