| NPI | 1902226962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401019479) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: SD LPC20726) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2022-06-06 |