| NPI | 1154762391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW005997) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC007025) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2020-08-16 |