| NPI | 1053064055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 8805) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA APC006799) |
| 101YP2500X Counselor, Professional (Licence: GA LPC013592) | |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2023-10-17 |