| NPI | 1053727206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA LPC009386) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AL 3551) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2017-01-23 |