NPI | 1467088898 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC011435) |
Additional Taxonomies | 101Y00000X Counselor (Licence: GA MFT001760) |
Enumeration Date | 2020-03-17 |
Last Update Date | 2020-03-17 |