| NPI | 1114666419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC009911) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: GA LPC009911) |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2024-11-19 |