NPI | 1073652582 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC000565) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC000565) |
106H00000X Marriage & Family Therapist (Licence: GA MFT000187) | |
Enumeration Date | 2007-02-05 |
Last Update Date | 2007-07-08 |