| NPI | 1053651612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: GA LPC007862) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KY KY-1503) |
| 101YP2500X Counselor Professional (Licence: GA LPC007862) | |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2024-07-16 |