| NPI | 1053854257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC011318) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA APC005700) |
| 106H00000X Marriage & Family Therapist (Licence: GA MFT001803) | |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2020-09-30 |