| 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 |