| NPI | 1235441809 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH10548) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC012398) | 
| 101YM0800X Counselor, Mental Health (Licence: FL IMH7183) | |
| Enumeration Date | 2010-07-12 | 
| Last Update Date | 2021-09-27 |