| NPI | 1891706164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 5636) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 11261) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2016-01-20 |