| NPI | 1902516784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL LPC04747) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AL 04747) |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2024-04-15 |