| NPI | 1023334984 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005306) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC005306) | 
| 102L00000X Psychoanalyst (Licence: GA LPC005306) | |
| Enumeration Date | 2010-04-15 | 
| Last Update Date | 2013-04-01 |