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 |