| NPI | 1962953745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC6642) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: DC PRC14826) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |