| NPI | 1215126099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC011286) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NC 6769) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2024-03-19 |