| NPI | 1114395340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC009957) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 20458) |
| 101YP2500X Counselor, Professional (Licence: VA 701013688) | |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2025-05-06 |