NPI | 1003183492 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006183) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA LMFT001140) |
Enumeration Date | 2011-11-29 |
Last Update Date | 2011-11-29 |