| NPI | 1396349304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC011580) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: KY 246091) |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2020-11-30 |