| 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 |