| NPI | 1164809836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: GA CSW007465) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: GA MSW006090) |
| 101YM0800X Counselor Mental Health (Licence: GA CSW007465) | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2023-08-18 |