| NPI | 1912308644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2017038398) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC.0011928) |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2018-03-17 |