| NPI | 1154558526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC005536) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA 203335) |
| 101YM0800X Counselor Mental Health (Licence: GA LPC005536) | |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2014-02-12 |