| NPI | 1023457546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AL 3290) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: GA LPC009881) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2021-08-17 |