NPI | 1053933259 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-42847) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC013013) |
Enumeration Date | 2020-05-11 |
Last Update Date | 2023-09-21 |