| NPI | 1053638668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005902) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC005902) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2020-02-04 |