| NPI | 1174643621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 000973) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA 000283) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-07-08 |