| NPI | 1912047622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401018259) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401009119) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-04-29 |