| NPI | 1104140573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006520) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA APC002402) |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2013-01-17 |