| NPI | 1487021697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC008455) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: GA LPC008455) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2016-01-01 |