| NPI | 1912259227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY 533) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS 303) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2012-10-10 |