| NPI | 1104274273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC008928) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC008928) |
| 101YM0800X Counselor Mental Health (Licence: GA LPC008928) | |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-05-31 |