| NPI | 1174793343 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006101) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC006101) | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA LPC006101) | |
| 101YM0800X Counselor, Mental Health (Licence: GA LPC006101) | |
| Enumeration Date | 2008-03-04 | 
| Last Update Date | 2019-02-18 |