| NPI | 1184960361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC008242) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701005372) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2023-03-31 |