| NPI | 1891351946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: PA PC001869) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: GA 390197) |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2020-01-27 |