| NPI | 1275178212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006049) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 511079) |
| 101YM0800X Counselor, Mental Health (Licence: GA LPC006049) | |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2019-11-13 |