NPI | 1265035588 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC011866) |
Additional Taxonomies | 101YS0200X Counselor, School (Licence: GA 1364266) |
101YS0200X Counselor, School (Licence: AL AXR-0108-7808) | |
101YP2500X Counselor, Professional (Licence: AL 3945) | |
Enumeration Date | 2020-11-19 |
Last Update Date | 2020-11-19 |