| NPI | 1902244767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401012274) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 12195) |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2013-06-13 |