| NPI | 1124440938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC007580) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH12019) |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2014-01-14 |