| NPI | 1356794085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC010649) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: PA PC013098) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2021-05-03 |