| NPI | 1164793436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC004357) |
| Additional Taxonomies | 101YS0200X Counselor School |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2012-01-19 |