| NPI | 1104230184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC010754) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: GA APC005357) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2022-04-11 |