| NPI | 1073023164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA LPC004808) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH7359) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2017-10-03 |