| NPI | 1902148059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 1642-226) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103TC1900X Psychologist Counseling (Licence: WI 5630-125) | |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2021-03-05 |