| NPI | 1992129415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0701006550) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC5175) |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2020-10-20 |