NPI | 1366579062 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: GA 2378LPC) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA LMFT 867) |
Enumeration Date | 2007-02-28 |
Last Update Date | 2007-07-08 |