| NPI | 1023564101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC009282) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC009282) |
| 101YM0800X Counselor Mental Health (Licence: GA LPC009282) | |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2019-03-04 |