| NPI | 1215508536 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC009419)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 15443)  | 
| Enumeration Date | 2021-07-07 | 
| Last Update Date | 2021-07-29 |