| NPI | 1215473624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: GA LPC009193) |
| 101Y00000X Counselor (Licence: GA LPC009193) | |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2020-07-08 |