| NPI | 1083979793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC010298) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH11415) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2019-03-05 |