| NPI | 1124677612 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC012472) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA APC006869) | 
| Enumeration Date | 2019-09-06 | 
| Last Update Date | 2025-08-21 |