| 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 |