| NPI | 1063540755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC011699) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH8721) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH11626) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2023-12-13 |