| NPI | 1154536159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC002647) |
| Additional Taxonomies | 104100000X Social Worker (Licence: GA LPC002647) |
| 106H00000X Marriage & Family Therapist (Licence: GA LPC002647) | |
| Enumeration Date | 2007-05-12 |
| Last Update Date | 2007-07-08 |