| NPI | 1174874473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: GA MH14010) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL IMH10399) |
| 101YS0200X Counselor School (Licence: FL 716753) | |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2017-10-13 |