| NPI | 1043319189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC001161) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA MFT000644) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2007-07-08 |