| NPI | 1033779392 |
|---|---|
| Former Name | GENEVIEVE FULLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA LMHC12513) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2023-09-12 |