NPI | 1124221585 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006881) |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health (Licence: GA LPC006881) | |
Enumeration Date | 2007-06-05 |
Last Update Date | 2023-10-25 |