| NPI | 1073688842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA LPC4235) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA NNC73246) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2007-07-09 |