| NPI | 1033590658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: GA CSW005452) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: GA CSW005452) |
| 102L00000X Psychoanalyst (Licence: GA CSW005452) | |
| 1041C0700X Social Worker Clinical | |
| 251S00000X Community/Behavioral Health (Licence: GA CSW005452) | |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2021-06-28 |