| NPI | 1982016986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180.009453) |
| Additional Taxonomies | 225600000X Dance Therapist (Licence: IL 1175) |
| Enumeration Date | 2014-05-24 |
| Last Update Date | 2015-01-07 |