NPI | 1497159685 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC0026575) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP2463) |
101YM0800X Counselor, Mental Health (Licence: FL MH7146) | |
Enumeration Date | 2014-10-16 |
Last Update Date | 2014-10-16 |