| NPI | 1962819714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC7037) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LGP5653) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2016-07-25 |