NPI | 1235580457 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC008573) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA MFT001448) |
Enumeration Date | 2016-06-29 |
Last Update Date | 2016-06-29 |