| NPI | 1104219617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 6677) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC010815) |
| Enumeration Date | 2015-03-07 |
| Last Update Date | 2019-10-02 |