| NPI | 1245410489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC004902) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC004902) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA LPC004902) | |
| 251S00000X (Licence: GA LPC004902) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: GA LPC004902) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: GA LPC004902) | |
| 283Q00000X Psychiatric Hospital (Licence: GA LPC004902) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: GA LPC004902) | |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2009-02-19 |