| NPI | 1962070656 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 5223) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 4751) | 
| Enumeration Date | 2021-06-17 | 
| Last Update Date | 2021-10-25 |