| NPI | 1194009811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC009752) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 18 007078) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2018-12-11 |