NPI | 1114405057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC010207) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 18562) |
101YP2500X Counselor, Professional (Licence: CA 18562) | |
Enumeration Date | 2018-08-02 |
Last Update Date | 2025-06-13 |