| NPI | 1891067385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OH E0002923) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: OH E0002923) |
| Enumeration Date | 2012-01-31 |
| Last Update Date | 2025-04-28 |