| NPI | 1902187495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AR P2106011) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 5519) |
| 164W00000X Licensed Practical Nurse (Licence: AR 214521) | |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2021-06-14 |