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 | 2023-12-03 |