| NPI | 1427459155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW005217) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA CSW005217) |
| 101YP2500X Counselor, Professional (Licence: GA CSW005217) | |
| 103K00000X Behavior Analyst (Licence: GA CSW005217) | |
| 106H00000X Marriage & Family Therapist (Licence: GA CSW005217) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA CSW005217) | |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2016-09-30 |