| NPI | 1013456763 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC011534) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AL LPC04855) | 
| Enumeration Date | 2017-02-14 | 
| Last Update Date | 2024-02-17 |