| NPI | 1407107543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC010686) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC0016921) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 1247) | |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2026-04-02 |