| NPI | 1356814727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA LPC010467) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC010467) |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2020-10-26 |