| NPI | 1164676789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005777) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH 0600467) |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2010-07-08 |