| NPI | 1104056456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: GA CSW004122) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: GA LPC005371) |
| 221700000X Art Therapist (Licence: 90-062) | |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2009-07-21 |