| NPI | 1902305733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 79494) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: PA PC010233) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2019-11-05 |