| NPI | 1003097072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005606) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2012-11-08 |