| NPI | 1447640990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC009964) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC009964) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health (Licence: GA LPC009964) | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2023-10-04 |