| NPI | 1992978563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NE 4121) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY 1212) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2012-09-30 |