| NPI | 1972766251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO 5734) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO 10202) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2018-03-23 |