| NPI | 1154482719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006555) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: GA OT001928) |
| 106H00000X Marriage & Family Therapist (Licence: GA MFT001195) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2012-01-13 |