| NPI | 1194082818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC004492) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 507430) |
| 103T00000X Psychologist | |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2024-01-26 |