| NPI | 1871993840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401014365) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401014365) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2018-05-04 |