| NPI | 1063779882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC006785) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: GA 006785) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2019-03-01 |