| NPI | 1043386238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC001697) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 001902) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-07-08 |