| NPI | 1326342098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC001690) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: GA LPC001690) |
| 106H00000X Marriage & Family Therapist (Licence: GA LPC001690) | |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2015-01-26 |